Professional Surgery Video-Cholesteatoma Canal wall down tympanomastoidectomy Inside-out technique

Professional Surgery Video-Cholesteatoma Canal wall down tympanomastoidectomy Inside-out technique by Dr Akbar Abbas who is an ENT surgeon, he specializes in otolaryngology, cochlear implants, ear surgery and is one of the few experts on pituitary and head and neck cancer surgery in Pakistan.

Cholesteatoma canal wall down tympanomastoidectomy is a surgical procedure performed to treat a middle ear condition called cholesteatoma. Cholesteatoma is an abnormal growth of skin cells within the middle ear, often occurring as a result of recurrent ear infections or a congenital abnormality.

The surgery begins with the patient under general anesthesia, ensuring they are unconscious and pain-free throughout the procedure. Once the patient is prepared and properly positioned, the surgeon starts by making an incision behind the earlobe, extending upward towards the temporal region of the skull. The incision is created to gain access to the middle ear and mastoid bone.

Next, the surgeon carefully dissects the layers of tissue and muscles to expose the mastoid bone and ear canal. Using specialized instruments, the surgeon removes the external auditory canal and part of the mastoid bone, which are considered the “canal wall down” technique. This approach is chosen when the cholesteatoma extensively involves the ear canal or mastoid, requiring more extensive removal for complete eradication.

During Cholesteatoma canal wall down tympanomastoidectomy, the surgeon follows an inside-out technique. This technique involves removing the infected tissue from the inner layers of the ear and mastoid bone before progressing towards the outer layers. By doing so, the surgeon minimizes the risk of spreading the infection or leaving any abnormal tissue behind. It also allows for better visualization and accessibility to ensure thorough eradication of the cholesteatoma.

Throughout the surgery, the surgeon uses various tools, including microscopes or endoscopes, to enhance visualization and precision. They meticulously remove the cholesteatoma, checking for any residual abnormal tissue, infection, or damage to critical structures like the ossicles (hearing bones) or facial nerve.

Once the surgeon confirms the successful removal of all abnormal tissue without causing damage to vital structures, they proceed to reconstruct the ear. This often involves using grafting techniques to rebuild the ear canal and mastoid cavity. The choice of grafting material may vary based on the surgeon’s preference and the patient’s individual characteristics.

After ensuring proper reconstruction, the surgeon closes the incision using dissolvable sutures and applies dressings to facilitate healing. After surgery, patients typically require post-operative care, including follow-up appointments, use of antibiotics, and regular ear cleaning to prevent recurrence or further complications.

Experience the Cholesteatoma Canal wall down tympanomastoidectomy Inside-out technique, start to finish. Cholesteatoma is a major cause of chronic ear discharge and potential cause of major morbidity. The video also shows the technique of wide meatoplasty.

This is an educational video for students and patients for making informed decisions about their own and others health. The surgery was performed by Dr Akbar Abbas who is one of the best ENT specialist in Karachi, Pakistan. He specializes in otolaryngology, cochlear implants, ear surgery and is one of the few experts on pituitary and head and neck cancer surgery in Pakistan. Presently serving at Aga Khan University Hospital.